title: Pain epidemiology and health related quality of life in chronic non-malignant pain patients referred to a Danish multidisciplinary pain center.
abstract: This paper presents the results of a detailed study of the pain epidemiology and health related quality of life (HRQL) in 150 chronic non-malignant pain patients consecutively referred to a Danish multidisciplinary pain center. Mean pain severity was 71.6 (SD = 18.5) on the VAS scale. Forty-two percent reported poor quality of sleep. HRQL was evaluated with the Medical Outcome Study-Short Form (SF-36), the Hospital Anxiety and Depression scale (HAD) and the Psychological General Well-Being Scale (PGWB). Compared with the normal population (NP) both SF-36 scores and PGWB scores were significantly reduced (P < 0.001) indicating that physical, psychological and social well-being were severely reduced. On the HAD scale 58% were found to have a depressive or anxiety disorder. Statistically significant but modest correlations were found between pain severity and HRQL. Psychological and social well-being was closely correlated. Sixty-three percent of the referred patients had neurogenic pain conditions. Of these, only 25% were treated with antidepressants or anticonvulsants at referral. Seventy-three percent were treated with opioids at referral. Mean opioid consumption was 64 mg of morphine per day (range 1-280 mg). Compared with the NP the chronic pain patients had used the health care system five times more often in the years prior to referral (P < 0.001). The study confirms the severe multidimensional impact of chronic pain and demonstrates that HRQL of chronic non-malignant pain patients is among the lowest observed for any medical condition.
authors.affiliation: Multidisciplinary Pain Center, Danish National Hospital, DK-2100 Copenhagen Ø, Denmark Frederiksborg General Hospital, DK-3400 Hillerød, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Becker
authors.forename: Annemarie Bondegaard
authors.initials: AB
authors.lastname: Thomsen
authors.forename: Alf Kornelius
authors.initials: AK
authors.lastname: Olsen
authors.forename: Per
authors.initials: P
authors.lastname: Sjøgren
authors.forename: Per
authors.initials: P
authors.lastname: Bech
authors.forename: Jørgen
authors.initials: J
authors.lastname: Eriksen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002908:Chronic Disease; D003710:Demography; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D018710:Pain Clinics; D011788:Quality of Life; D012890:Sleep / Q000502:physiology; D012959:Socioeconomic Factors
chemical_list: D000701:Analgesics, Opioid